| NPI | 1912239583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ANN MCCORMICK Lpc, Ncc 469-693-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 62863) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 62863) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2011-08-26 |